Thank you for your response to our whistleblowing article. Despite the fact that the article was published in 1998, we continue to get responses to it. It seems obvious to us that the whole issue of organizational ethics whistleblowing continues to strike a responsive chord. We are thankful to OJIN for continuing to make it available to its readers. The real tragedy is that whistleblowing has to happen to bring attention to issues in health care. The recent developments at Walter Reed Hospital in Washington, D.C. is further indication that all types of organizations do a poor job of policing themselves. As budget constraints, often driven by profit making pressures in health care, become even more pronounced, decisions impacting the health and well‑being of those health care serves become more troublesome. There is ample evidence that companies like Johnson & Johnson which put health and safety above profits are in the minority and that some sort of external oversight is necessary for health care. My coauthors and I think that JCAHO is in an ideal position to play such a role, but only if it rethinks what constitutes an organizational ethics issue. The current standards are too narrowly focused on the business aspects of the health care organization's relation to the public and completely ignore the problems of moral agency that nurses and other health care workers encounter in their daily routines. We think that there will only be change if organizations, such as the American Nurses Association, make a point of pressing for meaningful reform in the way that their members' moral agency is fostered and protected. Thanks, again for your interest.

James J. Fletcher
Professor Emeritus of Philosophy
George Mason University
Fairfax, VA